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That's surprising given the amount of data we got on the possible side-effects, especially the long-term ones </s>.
We have a lot of data about the side effects of getting the disease.
I am not disputing that part of the equation.
The choice right now is: take the vaccine, or get the disease. Particularly true of front-line healthcare workers. To choose the latter is idiotic.

Like, whatever side effect of the vaccine you are worried about, you will get the same or much worse from your immune reaction to the disease. That’s simple biochemistry—it’s the same spike protein in all relevant respects.

If healthcare professionals refuse the vaccine then why should the rest of us be vaccinated?

This behaviour sends an appalling message to the public.

Frankly, there should be serious consequences for the staff involved.

In 3 lines you've managed to write 3 conflicting views.

1. Some health workers might have different views, including very wrong ones on any kind of treatment. What does that change?

2. It does not. Whistle blowers always existed and in this case they are just wrong. You cannot control the mind of the whole medical industry.

3. I would also disagree with this one even if I don't agree with the staff that rejected the vaccines. They have their right to having their own opinion and that's good. I am free to disagree and I will.

There are no conflicting views in my comment.

Your comment illustrates what's wrong in the US and the West in general in a situation like this and has been made painfully visible this year even before this: individualism taken to the extreme, no consideration at all for the common good, no political courage to act in the common good above individuals.

The vaccine given to people has received approval from the relevant health authorities and is being rolled out as a matter of national priority in all countries. It is the best shot we have at ending this pandemic. Medical staff are at high risk and they are also critical, and people obviously look up to them on healthcare issues.

Therefore, medical staff have a duty (a concept that seems completely forgotten these days) to get vaccinated when called both for themselves, their patients, and as example to the public at large.

If that goes against their personal beliefs then they are in the wrong profession and should quit or be fired.

> Your comment illustrates what's wrong in the US and the West in general

I find comments are made much better (are more likely to influence someone’s thoughts) by just deleting these parts.

Try to communicate out of a desire to learn first, inform second, and just skip the shaming.

That's just an inflammatory reply that does not bring anything to the discussion, tbh.

I believe I made a point that is relevant and that has also been discussed in the media this year. A condescending attempt to dismiss it is poor form.

Effective communication includes phrasing arguments in ways that are less likely to trigger filters in the other party.

Lines like this make some people prone to just dismissing what you have to say because you come off as anti-US, anti-Western, pro-communist, or whatever they perceive that line to imply. It also looks like you are virtue-signaling to people who already share your point of view.

The point you make (e.g. societal concerns vs. individualism) IMO is valid. However, if the intent of your comment is to change minds it will fail because the way you have phrased it inherently puts people on the defensive.

Something I often hear at work about me that is valid here is "People rarely disagree with what you say but they disagree strongly with HOW you say it".

We both may wish people didn't care about the "how" if the "what" is correct but that's not the world we live in.

You're being dishonest by assuming the thing in question: whether the vaccine is safe. If it is in fact not safe, then medical professionals have a duty not to take it, as an example to the rest of us to avoid a politically-driven untested product. Don't forget that the manufacturers have been released from 100% of liability from any side-effect whatsoever.
A health care worker with covid when they should not have it because of access to vaccines is a potential super spreader vector to others that are not yet vaccinated or for whatever reason can't be. So to me that goes against the hippocratic oath. At a minimum they should have to disclose they are not vaccinated so patients can choose not to be around them. Though as others have said it sends a bad message to others that need it more. E.g. if I am a 25 year old that doesn't want to risk the side effects, 70 year olds with a heart condition and asthma that also decide against it with a very different risk profile have made a decision based on the young health worker...

That being said certain people like the pregnant woman that feels we don't have enough data if there are any I'll effects on that particular group seems relatively valid.

I thought the vaccine didn't stop the spread, just the disease? So the health care workers are going to keep spreading it either way.
It hasn’t been studied yet but it’s very unlikely this is true.

Is there any previous vaccine that this has ever been true of? If it was wouldn’t that enable the disease to continue to be rampant among groups who were not vaccinated?

A quick google shows it is starting to be studied now. We just don't know yet, and its not a sure thing. It may take a future generation of vaccine to be more effective at preventing transmission.

> The science behind this seeming contradiction is relatively straightforward. Vaccines like Pfizer’s and Moderna’s are injected into deep muscle and provide so-called systemic immunity. But they may still leave areas, particularly nasal mucous passages, where the virus is relatively free to multiply. Even without making the host sick, that virus can then potentially spread through coughing or sneezing, just as it is spread by a person with a full-blown coronavirus infection.

I’m fine with nurses not taking the vaccine but then they can only work with people who are already infected so they can’t infect others.
>If healthcare professionals refuse the vaccine then why should the rest of us be vaccinated?

Presumably, you would want to be vaccinated because it provides protection from contracting COVID. If you and anyone who wants it can get personal immunity, why does it matter others do?

Why should someone get a vaccine that health professionals consider too risky/not worthy?

That's very obviously my point...

You don't seem to realise how damaging their behaviour is for the uptake of the vaccine in the population at large. Nor do you seem to realise that this is not only a matter of personal immunity. The more people are vaccinated the more difficult it is for the virus to spread.

Lets try to tone things down a bit and have a polite conversation.

I think it would be helpful to clarify if you will personally refuse to get a vaccine because some healthcare workers will not, or are you talking about other people and excluding yourself?

If the former, the position is confusing because it holds that the choice of HC workers is wrong, but still allows it to have sway over your actions. If the latter, what sets your decision making process apart from the general population.

>Nor do you seem to realise that this is not only a matter of personal immunity. The more people are vaccinated the more difficult it is for the virus to spread.

Please explain it to me. Once everyone who wants personal immunity has access to the vaccine, why does it matter if the virus spreads?

> If healthcare professionals refuse the vaccine then why should the rest of us be vaccinated?

Because I don't base my health decisions on what nurses do or do not believe, for example.

My mother took a chemistry class for her permanent teaching certificate. It was a really good chemistry class and book--the book taught 6th grader me so much chemistry that I never took another chemistry class in my entire engineering education (electrical engineer--so not so critical).

The class had a bunch of nurses finishing up their training. The nurses complained bitterly about how hard the class was and that it was the blocker for graduating--in spite of it practically avoiding all math.

Cogitate on that--20+ year old college students couldn't understand a book that a 6th grader could.

Just because someone is a nurse doesn't automatically make them an authority on health decisions.

> Frankly, there should be serious consequences for the staff involved.

That will likely happen after Covid. Right now, everywhere is so short of staff that nobody is going to risk offending a qualified nurse and having them walk.

I experienced something similar in my intro to chem class when I was in uni. The people who were majoring in biochem to become physicians apparently couldn't handle basic division and multiplication and complained the class was too much work, it was rather appalling.
That's good, because then people who need it, can get it earlier. It's a personal decision, they can do what they want and many people want it as early as possible. In May it will be too late. Next time slot would be next fall.
Seems a simple choice. Get vaccinated or find work in another less critical area of the economy. This respects everyones personal choices.
Im not sure I follow the logic here. Healthcare workers are essential and in short supply, and the risk of catching covid is that they won't be able to perform their job while they recover. It seems that removing them from the job is just ensuring the downside.

I think a reasonable approach to the vaccine should at least include an optional roll out period. Some jobs require some vaccines, but these vaccines are well studied and have been used for decades. With a new vaccine, there are a number of factors that still need to be determined. The pregnant healthcare worker in the article is a great example of why flexibility is needed. Many existing vaccines are not recommended for pregnant women, and we don't have data on how this plays out for the new mRNA vaccines.

>the risk of catching covid is that they won't be able to perform their job while they recover.

No. The risk of a nurse catching COVID is that they will be an asymptomatic spreader and spread it to many other people in the hospital, including the new mother who just gave birth, the 25-year-old otherwise healthy car accident victim, and a half-dozen co-workers who will be going out in the community.

This is just the platonic ideal of HN, a bunch of engineers figuring that they can work out a better solution than the tens of thousands of public health scientists who have spent the past several decades working on vaccination and public health communication strategies.

Back in March we were told masks didn't work because there was a shortage and it was "the right thing to do" to say they didn't work. We were also told by high scientific institutions that closing borders was a bad idea.

Probably many people wonder now if the vaccine really is safe, or if it's just "the right thing to do" at the population level to get a lot of people vaccinated even if it's not safe. Hard to regain trust after dropping the ball so hard too many times.

TFA is extremely light on actual details of who is and who is not taking the vaccine.

Most importantly is that it’s perfectly valid for someone to be hesitant to take a newly released medical treatment. You won’t convince anyone to take the vaccine without first admitting their concerns are valid and trying to address them.

I would say there are two major groups who would most reasonably decline a vaccine. First, is anyone who has already had COVID. Natural immunity is more effective than the vaccine at preventing COVID, and I don’t know of a single case of someone spreading COVID after recovering. The vaccine on the other hand is not proven to prevent spread, and is not proven to provide longer duration immunity than natural infection. The article makes no mention at all of what percentage of health care workers declined a vaccine because they are already naturally immune.

Second, is anyone who is pregnant, as the vaccine is completely untested in that scenario. Curiously, TFA’s only specific example of someone who declined is someone who was pregnant.

Given the efficacy of the vaccine, anyone who hasn’t already had COVID who doesn’t want to get COVID should take the vaccine. Anyone who hasn’t already had COVID who doesn’t mind taking the risk of getting COVID can pass on it. We should give doses to those who want it, as fast as possible. Doses sitting on shelves are the biggest problem, because we are overly concerned with micromanaging the queue.

It’s like loading passengers on a plane. Going from front to back in strict order is the slowest possible way to do it. As I recall, a purely random ordering will load the plane at nearly the optimal rate, and if you include the time outside the plane spent on ordering, random is by far the fastest. COVID vaccination rate probably works about the same way.

I'm an emergency physician on the Navajo Nation in the US. I've seen multiple people quite ill the second time they've caught COVID (based on positive PCR twice, months apart, with compatible symptoms both times, resolution of symptoms in between, and a negative test in between). All had multiple sick family members the second time, hard to say who infected who, but I have no reason to believe they were not infectious the second time. (All were young and healthy, young children and youngish adults, seems like they were generally not very ill the first time so perhaps didn't mount a very robust immune reaction?) In speaking to colleagues that are hesitant about the vaccine, the evidence that having had COVID once does not guarantee protection against a subsequent and possibly more serious infection is actually something I specifically point out. Note that I'm not arguing that we have evidence that the vaccine guarantees long-lasting immunity either.

EDIT: typo

> Natural immunity is more effective than the vaccine at preventing COVID

You have no evidence of this and at least weak evidence to the contrary--both for COVID and other viral diseases.

The human immune system seems to be capable of clearing COVID with with the innate, non-specific immune response--especially in younger people. This will not necessarily provoke the antibody response that gives long term immunity.

A vaccine, on the other hand, is engineered to provoke a long-term response from the antibody system.

Of course we have evidence that natural immunity is more effective than the vaccine.

There have been tens of millions of people infected, and it’s front page news when they find someone who has been re-infected.

They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%.

> it’s front page news when they find someone who has been re-infected

Absolutely false. As I pointed out, I've seen multiple cases myself, as have many of my colleagues. Not only are they not newsworthy, they are hardly interesting at this point.

> They put the vaccine at about 95% whereas natural immunity is clearly upwards of 99.9%.

That's not true for any disease known to man.

In addition, the reason why reinfections are so "rare" medically is that the criteria for it are so stringent.

The patient has to have a positive COVID test, get over COVID, have a negative COVID test after long enough to believe that the virus cleared, catch the disease again after some time, and then get another positive test.

There are very few people who will meet that criteria given the rarity of COVID tests until about October.

Sadly, given the current rate of spread and the anecdotal evidence from others about reinfections, we should start getting enough people in that cohort to begin estimating the reinfection rate.

The analogy with loading a plane is poor. A seat is a seat and the aim is only to fill them as fast as possible.

On the other hand, with the covid vaccine not all injections are equal: some people have a higher risk of catching the virus, a higher risk of complications from the virus, a higher impact on society if they are off sick, a higher chance of spreading the virus, etc.

The aim is thus to get the maximum effect with each injection, especially when the supply of vaccines is limited.

Healthcare workers are critical and are at higher risk of catching the virus and of spreading the virus. For some of them at least vaccination should be mandatory for maximum impact and patients safety.

There is also symbolism and example: if healthcare professionals are wary of getting vaccinated then it sends a very bad message to the public that they should probably be wary as well instead of encouraging uptake.

In some countries, the President/PM took the jab live on TV. That's a form of leading by example and I believe healthcare workers of a responsibility to society on those issues.

> Curiously, TFA’s only specific example of someone who declined is someone who was pregnant.

This is false. The person you refer to, April Lu, is not the only specific example in the article, just the first. The second is Nicholas Ruiz, who I think it’s safe to say is not pregnant.

Honestly, the entire COVID response and vaccine initiative is in dire need of a good marketing campaign, perhaps alongside a healthy carrot and stick approach. We have the vaccine, and yet everything I hear out of officials mouths is doom and gloom, and equivocating about what it will take to be out of lockdown/protective measures. We understand nothing is certain in science or the virus, but you are experts and if you think something is 70%+ likely or not then tell us until proven otherwise.

Instead I would recommend the following.

1. Set a goal of the "best guess" of number of people needed to get herd immunity. Notice I said "best guess", we are never going to get it right, we are unlikely to actually completely achieve herd immunity. But compared to where we are now with a very small portion of the population having any immunity, and 70-85% of our citizens being vaccinated is a hell of a lot better then where we are now.

2. Plaster that count of people who have gotten immunized everywhere, time square, bottom of evening news, upper right of every newspaper. Make it aspirational for the nation to hit this number

3. Now for the hard part, when we hit it, remove protective measures. Yes its possible hospitals still have COVID patients, but I guarantee it will not be this crazy level of infection if we have 85% vaccination or similar. We will instead have isolated flare ups which can be dealt with on a regional basis. The US did this with small pox several decades ago. They would lockdown neighborhoods or even towns as flare ups happened. I've talked with seniors going through this about being in previous lockdowns when they were children, we have just forgotten this far back.

4. Now for the stick. I believe OSHA has indicated it is within an employers right to require vaccination, especially related to the pandemic. Use this aggressively. Pass protections for businesses, particularly freaking health care facilities, to consider failure to vaccinate (without certain medical exceptions) as cause for termination. It can be a gradual thing as vaccine availability comes online perhaps they are offered remote work if possible. However, when it hits general availability and you are still declining, then ultimately the business can't have you on their facility (or open themselves up to liability for unsafe work environment) and thus you are terminated. You are perfectly able to continue to decline, that is your right, but that does not mean you have continued employment at this organization.

In closing, I like all of you are freaking tired of this thing. I want to see the country looking forward to that magic day when this pandemic is over. Remember, the Flu from 1918 never went away, it just got a hell of a lot less deadly and people gained more immunity. It still throws our hospitals for a loop when we have a bad flu year. The goal is not to end COVID, it is instead immunity to the vast majority of us until the virus, naturally, continues its evolution to a less deadly form, and our population's immune system adapts as well. Here is hoping 2021-2022 has all the similarities of the roaring 20's after the 1918 flu, I'm certainly ready for a good time again!

I like the idea of OSHA involving OSHA and terminating anti-vaxxers employment.
Amazing how the article keeps saying "the vaccine is safe", "we know the vaccine is safe", when the actual experts, medical professionals, are the ones with doubts. We keep being told to "listen to the experts", but when the experts disagree with the politicians, suddenly it's "listen to the politicians".

Can someone who disagrees explain why I should suddenly not listen to the experts with skin in the game (hospital-based medical professionals) and instead listen to the same "experts" who said that we should not wear masks and should not close borders? And how many of those experts have publicly taken the vaccine, anyways? Seems almost like they've slotted themselves after the front-line workers.

Frankly I do not consider nurses to be experts on anything besides nursing (patient care). Whereas the experts on vaccines are toxicologists and pharmacologists, who do not appear to be the ones rejecting the vaccines. Physicians aren't even experts in these areas, as the information they use in deciding treatment is provided by expert researchers in the field.
The best decisions at the population level may not be the best decisions at the personal level. I think physicians should be able to make a decent call at the personal level.
I love the controversy here: on the one hand, people who don’t want the vaccine are to be pointed down as idiots, on the other the opinion of any healthcare professional is beyond reproach. Such a conundrum!
Frankly I do not consider nurses to be experts on anything besides nursing (patient care). Whereas the experts on vaccines are toxicologists, immunologists, and pharmacologists, who do not appear to be the ones rejecting the vaccines. Physicians aren't even experts in these areas, as the information they use in deciding treatment is provided by expert researchers in the field.